How it started! - The initiative of establishing a center of excellence in patient flow improvement fits well with the ambition of the VUmc to be a ‘Leader in patientflow improvement’. With the publication of the report   ‘Het kan écht: betere zorg voor minder geld’   [CEO Dutch Post, P. Bakker, 2004] the attention for the theme patient flow has only grown. In this center scientific research, education and improvement projects are joined together. We are specialized in the subject of hospital resource allocation in which managing variation in demand is crucial. Our ambition is to bridge the gap between the research community and health care professionals. We do this via constant testing and ultimately implementing our models and decision support systems in real practice.  

Methods - Our problem analysis and solving techniques originate from business administration, management science and operational research [1]. Operational research covers many analytic approaches and methods, such as simulation modelling, mathematical programming, decision analysis, cost effectiveness analysis, development of indicators, and methods for forecasting, monitoring and evaluation. In practice, this means we do thorough quantitative analysis of patient flow besides the qualitative analysis. Our methods can deal with the stochastic nature or variability  which characterizes so many health care processes. In almost every problem the challenge is about finding the balance between the costs and the service-level (quality) of the system.

Activities - The activities within PICA are threefold, 

  1. Scientific research
  2. Education & Training
  3. Improvement Projects

This website gives information on all these subjects.

These three activities are closely related. For example, in our projects we always try to apply results from our scientific research. With the feedback of the users, mostly managers and doctors, we modify and enhance our models and make them more applicable.


[1]   Operational Research (OR) is defined by Morse and Kimball [1951] to be "a scientific method for providing executive departments with a quantitative basis for decisions regarding operations under their control", with the added proviso that "quantitative aspects are not the whole story in most executive decisions"